121305613-7-15-2019-13-CC-CKRD-BE4TPM-20190715145435

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 121305613
Report Date: 07/15/2019
Date Signed: 07/15/2019 02:54:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	HSU CHILDREN'S CENTER PRESCHOOL		FACILITY NUMBER:	121305613
ADMINISTRATOR:	ELIZABETH WILSON		FACILITY TYPE:	850
ADDRESS:	HSU-MARY WARREN HOUSE 36		TELEPHONE:	(707) 826-4982
CITY:	ARCATA	STATE: CA	ZIP CODE:	95521
CAPACITY:	58	CENSUS: 17	DATE:	07/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Amy Pires / Elizabeth "Betsy" Wilson		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An annual inspection was made to the facility by Licensing Program Analyst (LPA) Chris Krogstad. The facility file was reviewed prior to this visit. This is a state funded combination preschool/toddler program, with a separate infant/toddler license, operated by Humboldt State University (HSU) (public agency). The director stated that all faculty and student staff are employed by HSU and obtain a criminal record clearance as a condition of employment. The preschool/toddler license operates in the Mary Warren house #36 (preschool) and the "Toddler Annex (toddlers)". The infant/toddler license operates in the Baiocchi House #37. The facility’s operating hours are 7:30am - 5:30pm, Monday-Friday, year round. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The preschool operates in the front Mary Warren house and the toddlers are housed in the back "toddler annex". Preschool and toddlers have separate rooms and play yards. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be stored out of reach and inaccessible to children. Poisons are locked a janitor cabinet in the staff restroom. The toys, floors, desks and other equipment and surfaces are clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children indoors and outdoors via drinking fountains. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Food is properly stored and refrigerated as needed. There was no contaminated food observed. Solid waste is properly disposed of. The LPA observed a working carbon monoxide detector in the facility. The playground was free of hazards. There were no structures observed that require cushioning material. There were no bodies of water observed on the property. The director stated no weapons are stored on site and none were observed. During today's inspection, Title 5 staffing ratios were being met. 14 preschool children were observed supervised by two teachers and two aides. Three toddlers were being supervised by two teachers and one aide. The facility was operating within the licensed capacity. All faculty present during the inspection possessed current CPR and First Aid certifications. 10 children’s records were reviewed at 1:30pm, and contained signed admission agreements. 15 staff records were reviewed at 12:55pm and contained documentation of education and training as required. See LIC 809C for continuation report.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Christen Krogstad	TELEPHONE: (530) 895-4230
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: HSU CHILDREN'S CENTER PRESCHOOL	FACILITY NUMBER: 121305613
	VISIT DATE: 07/15/2019

NARRATIVE

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This facility is not providing Incidental Medical Services (IMS) at time. The Incidental Medical Services (IMS) policy was discussed with the licensee. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the Director. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Christen Krogstad	TELEPHONE: (530) 895-4230
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019

LIC809 (FAS) - (06/04)

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